Phonomicrosurgical management of intracordal cysts

Patients with intracordal lesions complain of an increase in vocal roughness, early vocal fatigue, and a loss of range. The term intracordal may be misleading; the lesions discussed in this article are nonmalignant masses in or just below the epithelial cover of the vocal fold. Laryngeal videostroboscopy (LVS) is the gold standard for the evaluation of patient's intracordal lesions. The timing of surgery depends on the presence of continued dysfunction despite maximal medical and behavioral interventions. The microflap surgical technique is based upon the immunohistochemical characteristics of benign vocal fold lesions, including intracordal cysts. The dissection, within the superficial layer of the lamina propria, spares the overlying mucosal cover and underlying vocal ligament, optimizing vocal outcome.